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Required

 

PARTNERSHIP APPLICATION

PARTNERSHIP LEVEL
Business Category
Company Information
Your Namerequired
First Name
Last Name
Signature of Company Representative
Namerequired
First Name
Last Name
Must contain a date in M/D/YYYY format

Upon receipt of your Application, we'll send you an invoice.
The Partnership will proceed upon receipt of payment and is valid for one year from this date.

Questions? Contact

Paulien K. Rorick
Staff Associate for Digital Communications
(860) 236-8640 x170
prorick@capss.org